Cecilia C. Olazar, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

51858 Issued in FL

Practice address

130 Professional Dr
Ponte Vedra, FL 32082-6216

Phone

(904) 285-1113

Fax

(904) 285-3110

NPI assigned

Jul 5, 2005

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Arthritic Diseases Clinic

  • Medical Specialty Clinic/Center
  • Ponte Vedra Beach, FL
  • NPI 1124411525
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294790400000",
    "number": "1184621229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 PROFESSIONAL DR",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320826216",
            "telephone_number": "904-285-1113",
            "fax_number": "904-285-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 PROFESSIONAL DR",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320826216",
            "telephone_number": "904-285-1113",
            "fax_number": "904-285-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLAZAR",
        "first_name": "CECILIA",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-05",
        "last_updated": "2011-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "51858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alicia Ana Otero, MA; CCC-SLP
• Palm Leaf Dental
• Avelina Paly

• Specialist in Ponte Vedra, FL
• Providers in Ponte Vedra, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.